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Archives of Assessment Psychology

Abstract

This study examined whether the Brief Test of Adult Cognition by Telephone (BTACT), administered during acute rehabilitation, improved the prediction of 5-year functional outcomes after traumatic brain injury (TBI) beyond standard demographic and injury-severity variables. Data were obtained from the Traumatic Brain Injury Model Systems (TBIMS) National Database (N = 6,880; enrolled 2017 onward). Missing data were handled using multiple imputation (20 datasets). Hierarchical multiple regressions were conducted with the Functional Independence Measure (FIM) and the Glasgow Outcome Scale–Extended (GOS-E) as outcome measures. Demographics (age, sex, education, race) were entered in Block 1, injury severity indicators (post-traumatic amnesia [PTA] duration, Glasgow Coma Scale [GCS]) in Block 2, and the BTACT score in Block 3. Across models, injury-severity variables contributed the most to 5-year outcomes. Adding the BTACT score did not significantly improve predictive performance, and it was not an independent predictor of FIM (ΔR² = .072, p = .173) or GOS-E (ΔR² = .024, p = .334) in models adjusted for demographic and injury-severity variables. Results were consistent across the imputed and original datasets. Findings suggest that, in the presence of robust demographic and injury-severity indicators, brief telephone-based cognitive screening administered during acute care adds limited incremental value for predicting long-term global functioning after moderate-to-severe TBI.

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